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ANTI- INFLAMMATORY AGENTS

Very Important:

Bleeding is the most frequent complications following surgery. There are many across the counter medications as well as prescription medications and herbal medications that affect the activity of your platelets. It takes approximately 2 weeks for the platelets to obtain a normal activity after you discontinue these medications: this is why there is a need to be off these products for TWO WEEKS BEFORE and AFTER surgery.

AN EXCEPTION:

If you’re physician has placed you on aspirin or any medication to thin your blood because of medical reasons, please do not stop taking them without clearing it with your physician and notify Dr. Bartlett if you cannot safely stop them. The following is just a PARTIAL LIST of those medications, vitamins, and herbal remedies that affect your body’s ability to clot blood.

Aspirin (Anacin, Ascriptin, Bayer, Bufferin, Ecotrin, Excedrin)

Choline and magnesium salicylates (CMT, Tricosal, Trilisate)

Choline salicylate (Arthropan)

Celecoxib (Celebrex)

Diclofenac potassium (Cataflam)

Diclofenac sodium (Voltaren, Voltaren XR)

Diclofenac sodium with misoprostol (Arthrotec)

Diflunisal (Dolobid)

Etodolac (Lodine, Lodine XL)

Fenoprofen calcium (Nalfon)

Flurbiprofen (Ansaid)

Ibuprofen (Advil, Motrin, Motrin IB, Nuprin)

Indomethacin (Indocin, Indocin SR)

Ketoprofen (Actron, Orudis, Orudis KT, Oruvail)

Magnesium salicylate (Arthritab, Bayer Select, Doan’s Pills, Magan, Mobidin, Mobogesic)

Meclofenamate sodium (Meclomen)

Mefenamic acid (Ponstel)

Meloxicam (Mobic)

Nabumetone (Relafen)

Naproxen (Naprosyn, Naprelan*)

Naproxen sodium (Aleve, Anaprox)

Oxaprozin (Daypro)

Piroxicam (Feldene)

Rofecoxib (Vioxx)

Salsalate (Amigesic, Anaflex 750, Disalcid, Marthritic, Mono-Gesic, Salflex, Salsitab)

Sodium salicylate (various generics)

Sulindac (Clinoril)ToI metin sodium (Tolectin)

Valdecoxib (Bextra)

Note: Some products, such as Excedrin, are combination drugs (Excedrin s acetaminophen,aspirin, and caffeine).

Note that acetaminophen (Paracetamol; Tylenol) is not on this list. Acetaminophen belongs to a class of drugs called analgesics (pain relievers) and antipyretics (fever reducers). The exact mechanism of action of acetaminophen is not known. Acetaminophen relieves pain by elevating the pain threshold, that is, by requiring a greater amount of pain to develop before it is felt by a person. It reduces fever through its action on the heat-regulating center of the brain. Specifically, it tells the center to lower the body’s temperature when the temperature is elevated. Acetaminophen relieves pain in mild arthritis but has no effect on the underlying inflammation, redness and swelling of the joint.

Paracetamol, unlike other common analgesics such as aspirin and ibuprofen, has no anti-inflammatory properties, and so it is not a member of the class of drugs known as non-steroidal anti-inflammatory drugs or NSAIDs.

Additional list of medications that affect blood clotting (some of the medications listed may be duplicated from list above:

Antiplatelet Medication: ANAGRELIDE (AGRYLIN®), ASPIRIN (ANY BRAND, ALL DOSES), CILOSTAZOL (PLETAL®), CLOPIDOGREL (PLAVIX®), DIPYRADAMOLE(PERSANTINE®), DIPYRIDAMOLE/ASPIRIN(AGGRENOX®), ENTERIC-COATED ASPIRIN (ECOTRIN®), TICLOPIDINE (TICLID®)

Anticoagulant Medication: ANISINDIONE (MIRADON®), ARIXTRA, ENOXAPARIN (LOVENOX®) INJECTION, FRAGMIN, HEPARIN INJECTION, PRADAXA, PENTOSAN POLYSULFATE (ELMIRON®), WARFARIN (COUMADIN®), XERELTO

Nonsteroidal Anti-Inflammatory Drugs: CELEBREX, DICLOFENAC (VOLTAREN®, CATAFLAM®), DIFLUNISAL (DOLOBID®), ETODOLAC (LODINE®), FENOPROFEN (NALFON®), FLURBIPROGEN (ANSAID®), IBUPROFEN (MOTRIN®, ADVIL®, NUPRIN®, RUFEN®), INDOMETHACIN (LNDOCIN®), KETOPROFEN (ORUDIS®, ACTRON®), KETORLAC (TORADOL®), MECLOFENAMATE (MECLOMEN®), MELOXICAN (MOBIC®), NABUMETON (RELAFEN®), NAPROXEN (NAPROSYN, NAPRELAN®, ALEVE®), OXAPROZIN (DAYPRO®), PIROXICAM (FELDENE®), SALSALATE (SALFLEX®, DISALCID®), SULINDAC (CLINORIL®), SULFINPYRAZONE TOLMETIN (TOLECTIN®), TRILISATE (SALICYLATE COMBINATION)

Herbs/Vitamins: AJOENE BIRCH BARK, CAYENNE, CHINESE BLACK TREE FUNGUS, CUMIN, EVENING PRIMROSE OIL, FEVERFEW, GARLIC, GINGER, GINKGO BILOBA, GINSENG, GRAPE SEED EXTRACT, MILK THISTLE, OMEGA 3 FATTY ACIDS, ONION EXTRACT, ST. JOHN’S WORT, TUMERIC, VITAMINS C AND E.

List of Common Herbs and Vitamins:

Please discuss all herbal products, vitamins, over the counter, previous medications, and current medications with Dr. Bartlett.

Aloe Vera (Internal)………………………………………………..Asian Ginseng
Bayberry………………………………………………………………Black Cohosh
Blue Cohosh…………………………………………………………Bromelain
Caldendula…………………………………………………………..California Poppy
Cascara……………………………………………………………….Castor Bean
Cats Claw…………………………………………………………….Cayenne Pepper
Chamomile…………………………………………………………..Cinchona Bark
Dong Quai……………………………………………………………Dandelion
Evening Primrose…………………………………………………..Fenugreek
Feverfew………………………………………………………………Figwart
Garlic…………………………………………………………………..Ginger
Gingko Biloba……………………………………………………….Ginseng
Guggul………………………………………………………………..Hawthorn
Hops Horse Chestnut……………………………………………..Horsetail
Kavakava………………………………………………………………Lemon Balm
Licorice Root…………………………………………………………Ma Huang
Niacin………………………………………………………………….Passion Flower
Sagrada……………………………………………………………….St. John’s Wort
Valerian……………………………………………………………….Vitamin E
Willow Bar…………………………………………………………….Yohimbe

The above list includes common medications but is not a complete list.

Please check with Dr. Bartlett if in doubt.